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Ayurvedic formulations: Potential COVID-19 therapeutics?

ABSTRACT:

Background

While Molnupiravir and Paxlovid have recently been approved for use in some countries, there are no widely available treatments for COVID-19, the disease caused by SARS-CoV-2 infection. Herbal extracts have been used to treat respiratory clinical indications by Ayurvedic medicine practitioners with minimal adverse reactions and intense research efforts are currently under way to develop some of these formulations for COVID-19 treatment.

Methods

Literature search for in silico, in vitro, in vivo, and clinical studies on the topic of Ayurvedic formulations for potential COVID-19 treatment, in order to present the current state of current knowledge by integrating information across all systems.

Results

The search yielded 20 peer reviewed articles on in silico studies examining the interaction of phytoconstituents of popular Ayurvedic formulations with SARS-CoV-2 components and its receptors; five articles on preclinical investigations of the ability of selected Ayurvedic formulations to inhibit functions of SARS-CoV-2 proteins; and 51 completed clinical trials on the efficacy of using Ayurvedic formulations for treatment of mild to moderate COVID-19. Clinical data was available from 17 of the 51 trials. There was a considerable overlap between formulations used in the in silico studies and the clinical trials. This finding was unexpected as there is no clearly stated alignment between studies and the traditional pathway to drug discovery- basic discovery leading to in vitro and in vivo proof of concept, followed by validation in clinical trials. This was further demonstrated in the majority of the in silico studies where focus was on potential antiviral mechanisms, while the clinical trials were focused on patient recovery using oral treatments. In all 17 clinical trials where data was available, Ayurvedic treatments lead to a shorter period to recovery in participants with COVID-19.

Conclusion

The most commonly used Ayurvedic treatments for management of respiratory symptoms associated with SARS-CoV-2 infection appear to have prophylactic and/or therapeutic properties. It would be of particular interest to assess synergistic and concomitant systemic effects and antiviral activities of individual phytoconstituents and their combinations in the Ayurvedic treatments.

SUBMITTER: Mahaboob Ali AA

PROVIDER: S-EPMC9020642 | biostudies-literature | 2022 Aug

REPOSITORIES: biostudies-literature

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Publications

Ayurvedic formulations: Potential COVID-19 therapeutics?

Mahaboob Ali Anees Ahmed AA Bugarcic Andrea A Naumovski Nenad N Ghildyal Reena R

Phytomedicine plus : international journal of phytotherapy and phytopharmacology 20220420 3

<h4>Background</h4>While Molnupiravir and Paxlovid have recently been approved for use in some countries, there are no widely available treatments for COVID-19, the disease caused by SARS-CoV-2 infection. Herbal extracts have been used to treat respiratory clinical indications by Ayurvedic medicine practitioners with minimal adverse reactions and intense research efforts are currently under way to develop some of these formulations for COVID-19 treatment.<h4>Methods</h4>Literature search for <i> ...[more]

PMID: 35474908

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Project description:The current COVID-19 pandemic brought about by the SARS-CoV-2, a novel β coronavirus is creating intense health havoc globally. Researchers suspect the situation to stay for long in the community, considering this virus's pathogenesis, high rate transmission and tendency to provoke uncontrolled immune response activation. Immune mechanisms are highly individualistic. We put forward a hypothetical model of prakruti (Ayurvedic body phenotyping character) based personalized prophylactic-therapeutic strategies aiming at a better immunomodulation and quicker resolution of host immune mechanisms. We propose this model in symptomatic, mild to moderate, COVID-19 diagnosed cases and in cases quarantined for high to low risk primary contact with a positive case. We also suggest a community level personalized Ayurvedic prophylactic-therapeutic strategy based on the DOTS model. Person-centered body purificatory measures (panchakarma procedures) like therapeutic purgation (virechana) and medicated enema (basti) are suggested in this hypothetical protocol with justification on evidence-based links between immune responses and prakruti along with specific jwara (fevers of varied origin as per Ayurvedic sciences) and COVID-19 symptomatology. The paper also appraises the importance of pitta dosha/ama dosha in the manifestation of inflammation driven destructive phase of immune responses along with its stage-wise intervention. This hypothetical model intends to open up discussions on significance of prakruti assessment as a predictive marker to screen people who are at risk of succumbing into deteriorating states if infected with COVID-19. It also intends to discuss the predictive personalized medicine measures based on prakruti in yielding individual host immune homeostasis which may positively reduce the chances of untoward events of an aggravated immune responsiveness and subsequent inflammation driven tissue destruction - the candidate causes for COVID-19 related casualties. Testing this model may give insight towards emphasizing personalized host immune coping mechanisms that may prove crucial in any infectious outbreaks in near future too.

Project description:COVID-19, the disease caused by SARS-CoV-2, has been disrupting our lives for more than two years now. SARS-CoV-2 interacts with human proteins to pave its way into the human body, thereby wreaking havoc. Moreover, the mutating variants of the virus that take place in the SARS-CoV-2 genome are also a cause of concern among the masses. Thus, it is very important to understand human-spike protein-protein interactions (PPIs) in order to predict new PPIs and consequently propose drugs for the human proteins in order to fight the virus and its different mutated variants, with the mutations occurring in the spike protein. This fact motivated us to develop a complete pipeline where PPIs and drug-protein interactions can be predicted for human-SARS-CoV-2 interactions. In this regard, initially interacting data sets are collected from the literature, and noninteracting data sets are subsequently created for human-SARS-CoV-2 by considering only spike glycoprotein. On the other hand, for drug-protein interactions both interacting and noninteracting data sets are considered from DrugBank and ChEMBL databases. Thereafter, a model based on a sequence-based feature is used to code the protein sequences of human and spike proteins using the well-known Moran autocorrelation technique, while the drugs are coded using another well-known technique, viz., PaDEL descriptors, to predict new human-spike PPIs and eventually new drug-protein interactions for the top 20 predicted human proteins interacting with the original spike protein and its different mutated variants like Alpha, Beta, Delta, Gamma, and Omicron. Such predictions are carried out by random forest as it is found to perform better than other predictors, providing an accuracy of 90.53% for human-spike PPI and 96.15% for drug-protein interactions. Finally, 40 unique drugs like eicosapentaenoic acid, doxercalciferol, ciclesonide, dexamethasone, methylprednisolone, etc. are identified that target 32 human proteins like ACACA, DST, DYNC1H1, etc.

Project description:BackgroundAyurvedic clinical profiling of COVID-19 is a pre-requisite to develop standalone and integrative treatment approaches. At present, Ayurvedic clinicians do not have access to COVID-19 patients in clinical settings. In these circumstances, a preliminary clinical profiling of COVID-19 based on review of modern medical and classical Ayurvedic literature with inputs from Allopathic clinicians treating COVID-19 patients assumes significance.ObjectivesThis paper aims to develop an Ayurvedic clinical profile of COVID-19 by literature review supported by analysis of clinical data of a cohort of COVID-19 patients.MethodsThe typical clinical presentation of COVID-19 was categorized based on a cluster of symptoms with reference to "Interim Clinical Guidance for Management of Patients with confirmed corona virus disease (COVID-19)" released by the US CDC. As the clinical presentation is found to vary widely, research papers reporting clinical symptoms of patient samples from different parts of the world were also reviewed to identify outliers and atypical presentations. Case records of fourteen COVID-19 patients treated at Medanta Hospital, Gurgaon were analyzed to compare symptomatology with data obtained from published literature. Further, a careful correlation was done with the data collected from selected Ayurvedic classical texts and expert views of clinical practitioners to arrive at a preliminary Ayurvedic clinical profile of COVID-19.ResultsCOVID-19 can be understood from the Ayurvedic perspective as vātakapha dominant sannipātajvara of āgantu origin with pittānubandha. The asymptomatic, presymptomatic, mild, moderate, severe and critical stages of COVID-19 with varying clinical presentations have been analysed on the basis of nidāna, doṣa, dūṣya, nidānapañcaka and ṣaṭkriyākāla to present a preliminary clinical profile of the disease.ConclusionIn this paper, we have demonstrated that a preliminary clinical profiling of COVID-19 from the Ayurvedic perspective is possible through literature review supported by discussions with Allopathic clinicians as well as examination of patient case records. The provisional diagnosis proposed can be further developed with continued review of literature, wider cooperation and teamwork with Allopathic physicians and access to clinical data as well as direct clinical assessment of COVID-19 patients.

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Ayurvedic formulations: Potential COVID-19 therapeutics?

Background

Methods

Results

Conclusion

Publications

Ayurvedic formulations: Potential COVID-19 therapeutics?

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